| NPI | 1396025334 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IN 01074041A) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 000000000000000) | 
| 207R00000X Internal Medicine (Licence: IN 01074041A) | |
| Enumeration Date | 2011-08-22 | 
| Last Update Date | 2016-07-14 |